scholarly journals TCT-22 The STENTYS Self-Expanding Drug-Eluting Stent in Coronary Bifurcation Lesions at 6 Months Follow-up: Results from the OPEN II Trial

2013 ◽  
Vol 62 (18) ◽  
pp. B8-B9
Author(s):  
Christoph Naber ◽  
Holger Nef ◽  
Kelmak Külekçi ◽  
Carlo Briguori ◽  
Harald Rittger ◽  
...  
Keyword(s):  
Drug Eluting Stent ◽  
Coronary Bifurcation ◽  
Coronary Bifurcation Lesions ◽  
Drug Eluting ◽  
Bifurcation Lesions

P2693Late catch-up phenomenon and late-term target lesion revascularization of two-stenting for coronary bifurcation lesions between first and second generation drug-eluting stents

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Okabe ◽  
M Ohya ◽  
K Matsushita ◽  
A Kuwayama ◽  
R Murai ◽  
...  
Keyword(s):  
Stent Implantation ◽  
Target Lesion ◽  
Side Branch ◽  
Drug Eluting Stent ◽  
Coronary Bifurcation ◽  
Coronary Bifurcation Lesions ◽  
Drug Eluting ◽  
Bifurcation Lesions ◽  
Catch Up

Abstract Background The second generation drug-eluting stent (G2-DES) has been reported as superior to the first generation drug-eluting stent (G1-DES) in mid-term outcomes. However, the late-term outcomes between G1-DES and G2-DES in two-stenting for coronary bifurcation lesions are not well studied. Purpose To evaluate the late catch-up phenomenon and late-term target lesion revascularization (TLR) of two-stenting for coronary bifurcation lesions between G1-DES and G2-DES. Methods This study included 1133 lesions in 1089 patients undergoing drug eluting stent implantation with two stenting from 2004 to 2016. These consisted of 496 G1-DES implanted lesions and 637 G2-DES implanted lesions. Late-term follow-up angiography was performed without in-stent restenosis (ISR) and TLR at mid-term follow-up in 582 lesions (242 G1-DES lesions and 340 G2-DES lesions). ISR was defined as more than 50% restenosis. Late catch-up phenomenon was defined as ISR without ISR within 1 year following index stent implantation. Late-term TLR was defined as from 1 to 5 year TLR. Bifurcation lesions were defined as the main branch ranging from the proximal stem to the distal main branch with boundaries defined by 5 mm proximal and distal to the stent-implanted area, and the side branch ranging from the bifurcation carina to the distal side branch with boundaries defined by the carina and 5 mm distal to the stent-implanted area. Results The median follow-up duration was 5.1 years (the first and third quarters, 3.2 and 7.1 years). The late-catch up phenomenon rate significantly differed between the G1-DES and G2-DES groups (16.9% vs 8.4%, p=0.001). A significant difference in late catch-up between the same two groups was also observed in bifurcation lesions of the main branch (5.0% vs 0.6%, p=0.001) and side branch (10.3% vs 5.6%, p=0.033), respectively. The 5-year cumulative rates also differed between the two groups in TLR (8.2% vs 3.7% log-rank p=0.001), and late-term TLR (7.0% vs 3.6% log-rank p=0.001). Conclusion Two-stenting using G2-DES, compared with G1-DES, significantly reduced late-term restenosis and TLR. The restenosis rate in bifurcation area may be associated with differences between two groups in late-term outcome.

Abstract 12311: Side Branch Angle Influences the Neointimal Coverage of Drug-Eluting Stent in Coronary Bifurcation Lesions: An Optical Coherence Tomography Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Makoto Watanabe ◽  
Shiro Uemura ◽  
Youko Dote ◽  
Yu Sugawara ◽  
Yutaka Goryo ◽  
...  
Keyword(s):  
Stent Implantation ◽  
Side Branch ◽  
Drug Eluting Stent ◽  
Coronary Bifurcation ◽  
Coronary Bifurcation Lesions ◽  
Branch Angle ◽  
Bifurcation Lesion ◽  
Drug Eluting ◽  
Bifurcation Lesions ◽  
Neointimal Coverage

Background: Stent implantation for coronary bifurcation is intrinsically accompanied with inappropriate strut apposition around side branch (SB), which has potential risk for future development of stent thrombosis. Previous experimental studies indicated that side branch angle (SBA) influences the local flow turbulence and wall shear stress. The purpose of this study was to investigate the relation between SBA and the neointimal coverage of drug-eluting stent (DES) which were implanted in coronary bifurcation lesions. Methods: Forty-seven bifurcation lesions treated with DES were evaluated with FD-OCT in 39 patients (mean age; 65.7±13.9 y.o) at follow-up angiography. Each lesions were divided into the bifurcation lesions without kissing balloon technique (KBT) after stent implantation (non-KBT group; 28 lesions) and those with KBT (KBT group; 19 lesions). Neointimal coverage was assessed based on cross-sectional OCT images containing SB at 0.4mm interval, and separately evaluated in terms of jailing struts over the SB ostium (SO) and non-jailing struts attaching to the vessel wall (VW). BA was measured on the longitudinal reconstruction images of FD-OCT before stent implantation. Incidence of uncovered struts and neointimal thickness were measured. Results: In non-KBT group, the percentage of uncovered struts was significantly higher in lesions with SBA≦60°compared with those with SBA>60°at both SO and VW region (56.9±39.8% vs. 25.6±26.8%, p<0.05; 10.6±7.6% vs. 3.3±4.4%, p<0.01, respectively) and significant negative correlation was found between SBA and the percentage uncovered struts at both SO and VW regions (r=–0.55, p<0.01; r=–0.47, p<0.05, respectively). In KBT group, the percentage of uncovered struts was not significant difference between lesions with SBA≦60°and those with SBA>60°at both SO and VW region (36.7±35.3% vs. 36.6±34.8%; 10.9±10.4% vs. 8.6±12.7%, respectively) and no correlation was found between SBA and the percentage of uncovered struts at both SO and VW region. Conclusions: The neointimal coverage of DES was affected by in bifurcation lesion without KBT, but is not affected in bifurcation lesion with KBT. KBT has potential benefit for neointimal coverage of DES at coronary bifurcation lesion with narrow SBA.

scholarly journals Angiographic Restenosis in Coronary Bifurcations Treatment with Regular Drug Eluting Stents and Dedicated Bifurcation Drug-Eluting BiOSS Stents: Analysis Based on Randomized POLBOS I and POLBOS II Studies

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Robert J. Gil ◽  
Jacek Bil ◽  
Adam Kern ◽  
Luis A. Iñigo-Garcia ◽  
Radoslaw Formuszewicz ◽  
...  
Keyword(s):  
Stable Coronary Artery Disease ◽  
Optimization Technique ◽  
Drug Eluting Stents ◽  
Coronary Bifurcation ◽  
Coronary Syndrome ◽  
Angiographic Restenosis ◽  
Coronary Bifurcation Lesions ◽  
Drug Eluting ◽  
Bifurcation Lesions

Aim. The marked variation in bifurcation anatomy has brought about an ongoing search for stents specifically constructed for coronary bifurcations. This study aimed to analyze the angiographic restenosis prevalence and patterns and predictors of different patterns in dedicated bifurcation BiOSS® vs. current generation drug-eluting stents implanted in coronary bifurcation lesions based on data from two clinical trials POLBOS I and II. Methods. Dedicated bifurcation BiOSS® stents were compared with drug-eluting stents (DES) in patients with stable coronary artery disease (CAD) or nonST elevation acute coronary syndrome (NSTE-ACS) (POLBOS I: paclitaxel eluting BiOSS® Expert vs. DES; POLBOS II: sirolimus eluting BiOSS® LIM vs. DES). Provisional T-stenting was the default treatment. Morphological pattern of in-stent restenosis according to the modified Mehran classification adopted for bifurcation lesions was assessed with bifurcation dedicated quantitative coronary angiographic software (CAAS 5.11, Pie Medical Imaging BV, the Netherlands). Results. In total, 445 patients (222 patients in BiOSS group and 223 patients in DES group) were included into the analysis. In BiOSS group 24 cases of angiographic restenosis (10.8%) were recorded, and in DES group—17 cases (7.6%) at 12 months follow-up (angiographic control rate at follow-up—90.3%). In the BiOSS group most frequent medina classification in restenotic cases was 0.0.1 (25%), whereas in DES—0.0.1 and 0.1.1 (23.5% each). In multivariate regression analysis proximal optimization technique was associated with the lowest chance for restenosis (OR 0.15, 95% CI 0.06–0.33), whereas diabetes on insulin was associated with the highest risk of restenosis (OR 4.21, 95% CI 1.48–11.44). Conclusions. The angiographic restenosis pattern and rate was similar between BiOSS stents and DES in coronary bifurcation lesions.

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